Psychopathology Test 1

Psychopathology

the scientific study of mental difficulties or disorders, including their explanation, causes, progression, symptoms, assessment, diagnosis, and treatment. Describe the disorders directly

Deviance

different from cultural norms

Distress

cause of psychological distress (depression)

Dysfunction

interfere with daily functioning

Danger

danger towards themselves or others (suicide)

Culturally determined

Location and era, Simple problem with living, hard to fit in with social norms or what is seen as normal

Therapy

intentional treatment

Somatogenic

physical and biological causes of psychopathology

Psychogenic

psychological causes, can't observes, happens in the brain

East Asian Cultures

mind body disconnection, disharmony with nature

Indigenous Cultures

disconnection from community, self, nature (balance aspects of the self)

Scientific Method:

process that guides research, seeks to answer question, variables

Case Study

individual case, one person, specific event, clinical notes, records, rare cases, (Freud)

Pro: generate new ideas, support for theories, novel therapeutic interventions

Con: can be bias, subjective, no generalizability, replication

Correlational Design

extent to which event or characteristic vary with one another (relationships between variable), has magnitude (-1 to 1)

Direction

positive (same direction), negative (related but change opposite directions), unrelated (not related), Pro: generalize, apply to large group of people, many variables at same time, test theoretical relationships, replicable

Con: not equal causation, less depth, no account for exceptions

Experimental Design

change in one variable causes change in another, actively change variable,

Has control group, random assignment, masked design (reduced bias, does not know the research design)

Pro: compare treatments (clinical trial), causality, less confounding variables

Con: low external validity, threat to causal conclusions (regression to mean)

Model of Psychopathology

theoretical framework to explain phenomenon, explain behavior (born with, relationships, etc.), treatment plan, area for investigation, where concerns come from (different explanation for each model)

Biological Model:

Explanation: biological factors, evolution of time, genetics, epigenetics (how do genes play out due to lived experiences, trauma or stress)

Key factors: brain chem, neurotransmitters, hormones, brain circuit (information highway),

Treatment: drugs therapy, medication, brain stimulations, psychosurgery

Psychodynamic Model:

Personality, development, mental illness

Id (unconscious), Ego (conscious level), Superego (preconscious)

Explanation: where conflicts come from, developmental stages, past experiences, early relationships

Treatment: working through underlying conflicts, free association (talk about whatever needed), interpretation (resistance, transference, dream), catharsis

Cognitive-Behavioral Model:

Explanation: behavior influenced by conditioning (stimuli and reward, classical and operant), thoughts and irrational

Treatment: shift irrational thinking, exposure therapy, acceptance and commitment,

Humanistic-Existential Model

people are inherently good, self-actualization (live up to our potential), inability to be true self,

Humanistic theory:

conditions of worth (loved and accepted by others), self impose, internalized during childhood, client centered therapy, unconditional positive regard, empathy,

Gestalt theory

disconnection from present moment, client centered, focus on here and now, somewhat combative, role playing, empty chair,

Existential Theory

caused by self deception, hiding from responsibility, not finding meaning in life, focus on taking responsibility (life, problems), clarify values and goals, therapeutic relationship is key

Sociocultural Model:

caused by dysfunctional social systems

Family social theory

labels and roles, connection and support is key (structure and communication), where dysfunction is in the system, treat as a whole, group therapy, family therapy, couples therapy

Multicultural theory

culture (shared experiences), different psychologically, understand within the context of a certain culture (influence of prejudice), develop awareness of cultural values (client and therapist), discussion around intersections of identities, open to explore culture

Developmental Psychopathology Model

integrative many other theories, go through vulnerable periods (more or less influenced by lived experiences)

Equifinality

different pathways can lead to same disorder (Equal Final Point)

Multifinality:

many final point, same experiences lead to different outcomes

Treatment: not same treatment for all people, tailored to each client, early intervention, community based intervention

Assessement

collection of info to help find conclusion

Clinical assessment

IS behavior = mental health concern?HOW behavior is connected to mental health concerns? WHY behavior happening

Standardized, assessment conducted the same way across clinicians

Reliable, consistent results

Valid, measure what they should be measuring

Clinical Interview

first point of contact, variety of approaches, get broad picture of clients life and concerns, ex mental stats exam

Clinical Test:

more focused,

Projective test:

give neutral stimuli, word completion and sentences, poor reliability, personality inventories questions aimed at summarizing personality,

Neurological test:

more recent, EEG,

Clinical observation:

naturalistic observation, clients own environment, self monitoring

Classification

shared qualities or characteristics

Clinical Classification

shared symptoms (ex: DMS: big book of all distinct disorders , ICD)

Multiaxial Classification

in both DSM III and IV, diagnoses included info in each axis,

DMS V

does not have multiaxial diagnostic system, autism spectrum disorder is now all together, diagnosis of grief reaction

Diagnostic Information:

categorical, specific disorder, dimensional info, severity, code number to each disorder

Domains

more responsive to degree of concern, spectrum not category, help with comorbidity (multiple concerns at the same time ex: anxiety and depression)

Diagnosis

Pro: aid communication, helps research specificity, can be relieving for clients

Cons: reliability concerns, lead to stigmatization, each concern can look different

Evidence based practice:

best research, clinical experience, clients preferences and characteristics

Empirically supported treatments

treatment supported by research evidence, outcome studies, compared to control group and other therapies, better than no Tx or at least as effective

Treatment effectiveness

is therapy effective? therapy shown as effective, effect size = 0.8, go to therapy about 75% more better off

The Great Psychotherapy Debate:

what therapy is the most effective? Small differences between treatments, common factors

GAD General Anxiety Disorder

nervous, irritable, danger, doom, panic, difficulty sleeping, concentration problems (know as a free floating anxiety = not one specific thing that causes it)

Physiological symptoms (anxiety):

rapid breathing, sweating, shaking, fatigue, muscle, elevated HR,

Diagnoses GAD

at least 3 symptoms, difficult to control worry, at least 6 months

Prevalence GAD:

common, 3-5% a year, 7% lifetime, wide range of severity

Sociocultural GAD:

more stress= GAD, areas in poverty, crime, violence, higher rates durign COVID

Psychodynamic Theory GAD:

caused by development experiences, critical/ overprotective parenting, focused on processing childhood relationships

Humanistic GAD

low levels of self-acceptance, denial of thoughts, emotions, behaviors, conditions of worth

Cognitive Behavioral GAD

basic irrational assumptions

Rational Emotive Therapy GAD:

therapy approach, replace maladaptive assumptions, new ways of thinking

Metacognitive Theory

positive and negative beliefs about worrying, justify anxiety

Intolerance of Uncertainty Theory

able to tolerate uncertainty leads to anxiety, can be linked with parenting, negative events lead to anxiety

Avoidance Theory:

helps us deal with uncomfortable situations, physical sensations

Biological GAD

genetic predisposition, GABA neurotransmitter lower = over functioning fear

Phobia

more than a fear, persistent, immediate, unreasonable, intense, avoidance, dysfunctional, rarely useful

Fear

mild discomfort, slight impairment, may improve function, useful

Specific Phobia

specific object or situation, natural environment, animals, medical treatments

Agoraphobia

public spaces, difficulty escaping if somethings goes wrong, panic attacks, severity fluctuates

Cognitive Behavioral Explantation of Phobia:

Conditioning: phobias caused by conditioning (ex: little albert)

Modeling: phobias caused by observation, imitation, (ex: cartoons, other people)

Exposure Therapy:

Systematic desensitization: gradual exposure mixed with relaxation training, fear hierarchy, in vivo = in person, covert = imagined

Flooding: repeated exposure to feared stimulus, habituation,

Modeling: client observes, therapist confronts feared stimulus

Social Anxiety Disorder:

SAD: not just feeling nervous in front of others, fear and anxiety about one or more social situations, negatively evaluated by others, out of proportion with actual threat

Onset and Course: often with kids, shyness, stressful or humiliating experiences can trigger symptoms, fluctuate throughout life, generalized most versus nongeneralized specific

Panic Attacks

bursts of fear and or anxiety, sweating, tingling, chest pain, trouble breathing, fear of going crazy, fear of dying, occur suddenly, subside over time

Panic Disorder:

focus on panic attacks, repeated panic attacks

Diagnosis: at least one attack is followed by about a month of additional worrying or change in behavior

Prevalence: about 13-28 % panic attack in the course of life, about 5% in lifetime, early adulthood usually

Causes of Panic Disorder

neurotransmitter, brain structure, norepinephrine, misinterpretation of bodily sensations, anxiety sensitivity

Treatment for Panic Disorder:

cognitive behavioral therapy, relaxation training, medication

OCD:

Obsessive Compulsive Disorder, focuses on obsession and compulsion

OCD Obsession

persistent thoughts, ideas, images, cause distress or anxiety can't be ignored, avoidance, aggression, religion, hoarding

OCD Compulsion:

behavior or mental acts, repetition, response to rigid rules, try to reduce anxiety, not always connected to realistic ideals,

OCD Diagnosis:

presences of obsession, compulsion or both, time consuming activities, determine levels of insight into belief

Causes of OCD:

Psychodynamic, conflict of overt thoughts and behaviors, Biological, hyperactive brain response to impulse and needs, heighten reactions to intrusive thoughts

OCD Treatment:

medication, exposure therapy and ritual prevention, ERP, sometimes modeling

Stress

: event that demands change

Stress response

response to demand, endocrine system kicks in - cortisol, autonomic nervous system, involuntary body activity (ANS - sympathetic nervous system activation, Parasympathetic nervous system deactivation)

Common responses to traumatic stress:

fight, flight, freeze, fawn

Acute Stress Disorder + PTSD

Diagnosis

: exposure to traumatic event, can experience oneself or experienced by close other, exposure to details or outcomes of trauma, at least one intrusive symptom (affect day to day life), avoidance, negative impact on mood, heightened arousal or reactivity

Acute Stress Disorder

short term issue, within 4 weeks, symptoms last less than a month

PTSD

long term issue, symptoms begin at any time, longer than a month, years or lifetime, can start as acute stress

Acute Stress Disorder + PTSD, Prevalence

can begin at any age, high comorbidity anxiety, depression, substance abuse

Acute Stress Disorder + PTSD, Factors

combat or war, disasters or accidents, victimization, over reactive stress pathways (HPA), inherited predisposition, childhood experience, chronic neglect and abuse, other childhood predictors, severity (increased, prolonged, intentional acts),

Complex trauma:

multiple traumatic events in a short period of time, usually lead to more negative outcomes, impact self image and relationships, connect with personality disorders

Acute Stress Disorder + PTSD, Treatment

drug therapies, medications, anti-depressents, (reduce emotional arousal) effective about half to time, prolonged exposure therapy, eye movement desensitization and reprocessing therapy (EMDR), psychological debriefing, immediate intervention, normalize reactions, psychological first aid

Dissociative Amnesia

inability to recall information from ones life, autobiographical memory loss, stressful, traumatic

Dissociative Amnesia Localized:

loss of all memory from a specific time range

Dissociative Amnesia Selective:

remember some but not all evenet from a time period

Dissociative Amnesia Gneralized

memory loss of event, and many things before the event

Dissociative Amnesia Continuous:

memory los of event, and subsequent experiences

Dissociative Fugue:

extreme dissociative amnesia, forget personal identity, details of past life, new name, common after times of stress, disasters, war

Dissociative Identity Disorder:

aka multiple personality disorder, two or more distinct personalities, primary personality,

Subpersonalities:

mutually amnesic relationships, not aware of each other, mutually cognizant relationships, one way amnesiac relationships,

Dissociative Disorders Theory and Treatment

Psychodynamic Theory, work through repression, conscious, history of abuse, cognitive behavioral, state dependent learning, self hypnosis, avoid or forget unpleasant events, hypnotherapy, memory recall, medication,